Problems with the colon, or large intestine, can cause pain in the lower abdomen. Possible causes include constipation, diarrhea, and a range of gastrointestinal problems such as irritable bowel disease or colitis. Treatment will depend on the cause.

Inflammation, irritation, and obstruction in the colon can all cause pain, which a person will typically feel as abdominal pain. Possible causes of colon-related abdominal pain include constipation, irritable bowel syndrome (IBS), and colorectal cancer.

This article examines how disruptions in the colon may cause abdominal pain. It also looks at their causes and treatments and explains when a person should contact a doctor.

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The colon is about 5 feet in length, and it circles through the abdomen and down to a person’s rectum. The colon contracts to move digested food and waste toward the rectum. In a healthy colon, these contractions are painless, and people rarely notice them.

However, irritation, inflammation, and obstructions can cause strong contractions, resulting in pain.

The colon’s winding path through the abdomen can mean that a person feels pain throughout this area of the body if they experience colon disruptions.

However, it is also possible to feel pain only in a specific spot. Some people may also feel pain in the rectum, just above the anus. This pain may feel sharp and stabbing or dull and aching.

Several medical conditions and temporary digestive issues can cause abdominal pain.

Constipation

When stool is too large or hard, it cannot comfortably pass out of the colon and rectum. This can cause abdominal pain and pain near the rectum and anus.

Sometimes, hard stools can cause tears in the lining of the anus, known as anal fissures. People with anal fissures may experience bleeding and pain with bowel movements.

People with constipation may need to make certain dietary adjustments to help soften the stool and allow it to pass more easily. These include:

Certain medications can also cause constipation. A person with medication-related constipation should talk with a doctor if this side effect is causing them distress.

Learn more about constipation.

Diarrhea

Diarrhea has several possible causes, including hypercontractility. This term refers to the colon contracting too often, causing watery or loose stools three or more times a day. It has a variety of possible causes, ranging from food intolerances to viruses and bacteria.

Learn more about the different causes of diarrhea.

These fast contractions may cause abdominal pain and cramping. Loose stools may also irritate the anus, causing burning and stinging.

Diarrhea is often short-lived if a virus or food intolerance causes it. However, some bacteria and illnesses that cause diarrhea can be severe and potentially lead to dehydration.

Over-the-counter (OTC) antidiarrheal medications may help treat acute diarrhea. However, parents and caregivers should consult a doctor before giving a child OTC drugs.

Learn more about what to eat when experiencing diarrhea.

Irritable bowel syndrome

IBS is a digestive condition with symptoms that often affect the colon. IBS can cause stomach pain and cramping, usually around the time of a bowel movement.

IBS may also cause:

Learn more about the symptoms of IBS.

No single diet or medication can cure all cases of IBS, but various lifestyle adjustments may help. These include:

  • eating more fiber
  • avoiding gluten and other known trigger foods
  • following a low FODMAP diet
  • practicing stress management techniques
  • keeping a food diary to identify triggers

Diverticular disease

Diverticulosis is a condition in which the colon forms small pouches, or sacs, in its walls. According to the National Institute of Diabetes and Digestive and Kidney Diseases, it affects more than 30% of adults aged 50–59 years in the United States and more than 70% of those older than 80 years.

If any of these sacs become inflamed or infected, which is known as diverticulitis, this can cause pain, bleeding, and other symptoms.

In addition to abdominal pains, diverticulitis can cause:

  • loose stools or diarrhea
  • cramping in the lower abdomen
  • blood in the stool
  • fever
  • nausea
  • vomiting

Having regular bowel movements reduces the risk of developing diverticulosis and diverticulitis. Adopting a high fiber diet, exercising often, and staying hydrated can help promote regular bowel movements.

People who have symptoms of diverticulitis should see a doctor. In rare cases, diverticulitis can lead to serious complications.

Learn more about diverticular disease.

Colitis

Colitis refers to a group of conditions that cause inflammation in the colon. These conditions include:

  • Ulcerative colitis: Ulcerative colitis is a type of inflammatory bowel disease (IBD) that involves chronic colon inflammation with ulcers or sores.
  • Crohn’s disease: Crohn’s disease is another type of IBD. A person with Crohn’s disease will experience inflammation that can affect the entire digestive tract.
  • Infectious colitis: In this condition, bacteria, viruses, or parasites cause irritation and swelling of the colon.
  • Ischemic colitis: Ischemic colitis causes reduced blood flow to the colon, which may result in pain and damage.
  • Radiation colitis: Undergoing radiation therapy for cancer sometimes causes radiation colitis.
  • Microscopic colitis: In microscopic colitis, the inflammation is only visible upon microscopic examination of tissue samples.

Colitis can cause pain in the abdominal area. It may also cause:

A person may need medications, IV fluids, or antibiotics to treat colitis. Severe colitis sometimes requires surgery.

Colorectal cancer

Colorectal cancer starts in the colon or rectum. It is the third most common cancer diagnosis in the U.S., excluding skin cancer.

Colorectal cancer can cause abdominal pain near the area of the colon, as well as:

  • changes in bowel movements, such as constipation or diarrhea
  • bright red blood in the stool
  • an urgency to have bowel movements that then do not provide relief
  • dark stool
  • fatigue
  • unexplained weight loss

It is important to note that many people with colorectal cancer do not experience symptoms right away. Undergoing a colonoscopy is the best way to detect colorectal cancer early.

Colorectal cancer treatment may include medications, chemotherapy, radiation therapy, and surgery.

Learn more about colorectal cancer.

Abdominal pain has many possible causes, so no single test or exam can confirm a diagnosis.

A doctor may initially suggest making dietary changes for mild symptoms. They may also carry out procedures to examine the colon, such as a colonoscopy or sigmoidoscopy. Sometimes, people may also need blood tests, stool tests, or CT scans.

A doctor will consider a person’s symptoms and medical history before recommending further tests.

The treatment for abdominal pain depends on its cause.

After a person receives a diagnosis, they may need to make dietary or lifestyle changes, such as:

  • consuming more dietary fiber
  • avoiding foods that irritate the colon
  • quitting smoking, if applicable

Medications, surgery, or other procedures may also be necessary in some cases.

People with abdominal pain should speak with a doctor if pain or bowel changes last longer than a few days.

Most pain in this area of the body is due to temporary digestive trouble. However, it is best to speak with a doctor to rule out serious medical conditions, such as IBD or colon cancer.

Abdominal pain and colon disruptions are not always a sign of something serious. Most of the time, certain foods or even stress can cause digestive trouble that will eventually go away on its own.

However, a person with ongoing pain or any other problems with the bowel should speak with a doctor to determine the cause and whether treatment is necessary.